BACKGROUND: Penehyclidine is a newly developed anticholinergic agent. We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning (OP) patients. METHODS: We searched the Pubmed, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBM) and Wanfang databases. Randomized controlled trials (RCTs) recruiting acute OP patients were identified for meta-analysis. Main outcomesincluded cure rate, mortality rate, time to atropinization, time to 60% normal acetylcholinesterase (AchE) level, rate of intermediate syndrome (IMS) and rate of adverse drug reactions (ADR). RESULTS: Sixteen RCTs involving 1,334 patients were identified. Compared with the atropine-or penehyclidine-alone groups, atropine combined with penehyclidine significantly increased the cure rate (penehyclidine+atropine vs. atropine, 0.97 vs. 0.86, RR 1.13, 95% CI [1.07–1.19]; penehyclidine+atropine vs. penehyclidine, 0.93 vs. 0.80, RR 1.08, 95% CI [1.01–1.15]) and reduced the mortality rate (penehyclidine+atropine vs. atropine, 0.015 vs. 0.11, RR 0.17, 95% CI [0.06–0.49]; penehyclidine+atropine vs. penehyclidine, 0.13 vs. 0.08, RR 0.23, 95% CI [0.04–1.28]). Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery, the rate of IMS and the rate of ADR. Compared with a single dose of atropine, a single dose of penehyclidine also significantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS. CONCLUSION Atropine combined with penehyclidine benefits OP patients by enhancing the cure rate, mortality rate, time to atropinization, AchE recovery, IMS rate, total ADR and duration of hospitalization. Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.

Objective To investigate the rehabilitation needs and technical support for people with disabilities in rural areas. Methods From October, 2017 to February, 2018, 800 persons with disabilities, aged five to 80 years, from 23 villages in five township, Xi'an, Shaanxi, were surveyed with self-designed questionnaire and interview, including the basic situation, disability and training plan, rehabilitation support and skills maintained. Results The persons were mainly aged 50 to 80 years (58.37%), male (65.37%), accepting middle school education or less (46.63%), married (70.63%), living with their family (77.38%), income less than 2000 Yuan (66%), mainly from their family labor (62.62%). Their disabilities were mainly of grade 3 (40.63%), from hemiplegia (30.63%), dependence in living (45.38%), and no systematic rehabilitation program (55.25%). Most of them needed rehabilitation of self-care (40%), accessible guidance (30.63%) and reimbursement from medicare of Rural Cooperative Medical Scheme (50.63%), and hoped to participate social activities (41.87%). The rehabilitation supports were as that: the rehabilitation services were mobile or none (67.58%), the guiders of rehabilitation were few or none (48.88%), knew some or less rehabilitation knowledge (64.25%), the professionals accepted no continue education training (40%).Conclusion It is important to improve the rehabilitation technical support system for rural people with disabilities.